﻿Traditional, not conventionaL.﻿

Avoiding Malpractice (September 2, 2014)

When you start rummaging through the literature on this subject, you see that it is mostly written from a doctor's point of view and you find stuff like discussion on the correct wording of a consent form, observations on doctor affability and the like, and generally a whole lot less on the subject an ordinary person might expect to find – which is how not to commit malpractice in the first place. Why is that? Well, interestingly, because harming someone isn't of itself usually enough reason for them to sue. Here are the four most common reasons people give when they are asked why they are suing their doctor:

1) a desire to prevent a similar incident from happening again; 2) a need for an explanation as to how and why an injury happened; 3) a desire for financial compensation to make up for actual losses, pain, and suffering or to provide future care for the injured patient; and 4) a desire to hold doctors accountable for their actions.

“Medical error” is one of the top leading causes of death, so it's not hard to see that if everyone sued every time they got hurt by a medical doctor we’d all be so busy suing or being sued that there would be no time for keeping up with Bates Motel. Far fewer than 2% of incidents of malpractice result in claims being filed. People don’t sue because their doctor messed them up – they sue because they are angry at him/her for doing so.

[Regarding 3), I’d like to say that the way our society is currently organized, if you ARE seriously hurt by the medical system, often the only hope you have of staying out of Tent City is to sue the doctor that harmed you. If we had a better social safety net in the U.S., I think you’d see far fewer malpractice lawsuits. But then, that’s just me.]

With this in mind, in order to decrease the likelihood of being sued a not-so-clever doctor will focus on paperwork and ordering a lot of unnecessary tests. A smarter and more conscientious doctor will focus on patient communication. A REALLY smart doctor will focus on not committing malpractice in the first place, but that’s very very difficult – modern medical practice produces a truly remarkable amount of patient injury as a matter of course just because of the drastic nature of so many of the treatments. So the overall smartest thing for a doctor to do to decrease malpractice claims AND ensure good patient care is to make sure there is good communication.

Good doctors make sure that they are approachable and that you feel safe asking them questions. They take a complete medical history, make sure that they understand your problem and inquire into different aspects of it that you may not have thought of yourself. They will ensure that you understand what your diagnosis means, what the treatment options are and how they work and the positives and negatives of each one. They will see to it that you understand the trajectory of your disorder and what to expect and to watch out for. I mention all this here because this is also YOUR opening for YOUR best shot at avoiding malpractice – and that is to make sure that you understand your problem not just completely, but well enough to be able to consider any alternatives that your doctor doesn’t offer you.

Drugs and surgery ARE medical practice, and they are what medical doctors go to school for so many years in order to learn. When you are an expert in something, you know that subject inside and out but you know other things far less well, even if those things could be more helpful under some circumstances than what you spent so much time studying. Even with the continuing avalanche of information on how different aspects of lifestyle affect the course and even the onset of so many disorders, what your medical doctor is good at is drugs and surgery. Don’t expect him or her to be able to advise you at a truly expert level on any other alternative therapies. It’s up to you to understand your problems at least well enough to know when to consult a different expert when necessary. No one can be an expert on everything, and no one else will ever understand your own body as well as you can.

And of course if your doctor isn’t open to this kind of communication, find another doctor. Good patient care does not happen in a vacuum. It is always, always a partnership between the patient and the expert s/he is consulting. So don’t sue your doctor – make sure you’re treated properly in the first place.

The fundamental reason that there are so many medical malpractice claims is not that people are greedy and lawyers are dishonest, but because there is so much malpractice in the first place. And that is at least partly because so much “good” medicine often has very severe accompanying adverse effects, even when it works properly. Which brings me to my other topic today… [Questioning Statins]